How to terminate the pandemic: strategies to get Britain out of a continuous cycle of lockdowns
When the Government published its roadmap out of the pandemic in July, it was hoped that social distancing could be eased by November, and local lockdowns would only be needed “as a last resort”.
Roll forward three months and the position is altogether more bleak. Local restrictions seem to be doing little to curb the spread of infections, test and trace is failing to pick up tens of thousands of cases each day, and deaths are on the rise. So how do we get out of the lockdown and lift cycle? Here are five strategies scientists think could work:
Whack-a-mole and wait
The current strategy being deployed by the Government is to suppress the virus in hotspots, while allowing areas with low infection rates to have more freedom.
Keeping the virus at manageable levels prevents the NHS from being overwhelmed while buying time for vaccine trials to be completed and new drugs to be tested.
A source close to the Government’s science team told The Daily Telegraph that under such an approach, life could be returning to normal by the end of spring. “Maybe by late next spring, early next summer, life might be getting back to normal,” the source said. “Medical care will continue to improve and we will see new drugs, and so, come springtime, it starts to look like we’ll have a long-term sustainable way out of this.”
Elimination
Although many scientists now believe that coronavirus will become endemic – like flu – others think we should be trying to eliminate it completely.
If a vaccine becomes available, some countries are now considering “ring vaccination” which involves rapidly identifying those infected and then inoculating their contacts to avoid the virus spreading further.
The strategy has ended ebola outbreaks in Africa and was used in the eradication of smallpox, the only human disease that has ever been successfully wiped out. Such an approach would require strict border controls and quarantines from all countries to avoid new infections once cases were low in Britain. It would also need a highly responsive test, trace and vaccinate system.
Prof Devi Sridhar, of the University of Edinburgh, said: “Either we live with daily restrictions and lockdown cycles but we have open borders, or we close the borders and we largely get back to normal. The Government is trying to protect business but uncontrolled transmission is far worse for the economy. Early intervention and strong measures give people more confidence.”
However, Sir Patrick Vallance, the Government’s Chief Scientific Adviser, has warned that such an approach is not feasible.
Full lockdown and wait
Many scientists believe that Britain is now seeing a deadly second wave because restrictions were imposed too late and lifted too early.
A full lockdown that lasts until the virus is very low, or drugs and a vaccine are available, may be the only way of getting out of the cycle. Dr Stephen Griffin, of Leeds School of Medicine, said: “The simple fact is that measures were relaxed too soon and too much, the tone of messaging was that the worst was over, and much of the support that allowed those least well off or most clinically vulnerable to take appropriate precautions was removed. How to avoid lockdown cycles? Simple: make them count, and face the short-term hardship for the greater long-term good.”
Doctors and scientists are also hopeful that as well as a vaccine, drugs will be available which can lower the death rate to something closer to flu. If that happens, the virus would become endemic and the country could return to normality.
The Recovery trial, led by Oxford University, has found that the common steroid dexamethasone can lower death rates by a third. Prof Martin Landray, co-lead of the trial, said: “If we can find two or three drugs to turn this disease from something that kills one in three in intensive care to one in 10, then this turns it into something resembling seasonal influenza, then it ends the cycle of lockdown.”
Herd immunity
Thousands of clinicians and scientists throughout the world now believe that protecting the elderly and vulnerable while allowing herd immunity to build in the population is the best way out of the pandemic.
Prof David Livermore of the University of East Anglia was one scientist who signed the Great Barrington Declaration, which called on governments to adopt herd immunity globally.
“I think we have to learn to live with this virus, and we would be foolish to bet on a good vaccine” he said.
“The problem of lockdowns is they kick the can down the road and do huge damage. This virus is behaving seasonally, you look at other countries and despite having different measures they are seeing similar trajectories.”
A change of tack
A complete volte-face on how Britain is responding to the disease is the way forward according to some experts.
Prof Ashlely Woodcock of the University of Manchester, does not believe the virus is airborne, but is largely being transferred on surfaces. Shifting the focus to cleaning homes and public amenities could rapidly stop the spread, he believes.
He said: “Nobody has identified coronavirus in the air in Sainsbury’s or a school or a pub.
“What they have done is found it everywhere on surfaces, on cash machines, on phones, on supermarket tills. We need to have a ‘let’s clean Britain’ campaign”.